Longevity and stability

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Letitia Hubbard
8 years ago
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2 Why dual mobility? Small head diameter reduces wear the "LOW FRICTION" principle Large head diameter provides good joint stability The combination of these two concepts reduces wear while ensuring good stability with a dual mobility design Longevity and stability Two concentric articulations that resist wear and improve stability: The small articulation, more often loaded, preserves the polyethylene The large articulation, loaded at the extremes of ROM, ensures stability

combination of these two concepts reduces wear while ensuring good stability with a dual mobility design Longevity and

3 Overview of the concept Since the early 1980s, the clinical effectiveness of the dual mobility concept has been proven in terms of: - better joint stability - greater range of motion In primary arthroplasty, as well as in revision or acetabular reconstruction cases, this concept covers a range of homogeneous implants. CEM Quattro cup / Marc. K cross plate HAP Quattro cup Press Fit HAP Quattro VPS cup CEM Quattro cup

as well as in revision or acetabular reconstruction cases, this concept covers a range of homogeneous

4 Technical features that meet your needs Retention of the implant head: Pure hemispheric shape: m prevents risk of damaging cam effect between implant neck and cup edge m compatible with preferred cup inclination to prevent psoas impingement and risk of posterior dislocation m head passes through a restriction that is smaller than its diameter m optimal height of polyethylene insert which does not compromise strength at the material's elastic limit and avoids any plastic deformation A Modeling of polyethylene stresses and deformation during passage of the head - A long descending insert: eliminates risk of altering diameter at restriction point - B shortened insert: excessive stresses cause irreversible deformation of restriction point B Cobalt-chrome metal alloy: m optimal rigidity of the cup m hardness reduces risk of scratching m sphericity maintained during entire life of implant Porous titanium sublayer: m vacuum-plasma sprayed to reduce risk of weakening the implant interface m surface roughness essential to obtain the "anchoring volume" x primary implant fixation x secondary fixation through binding of newly formed bone into the pores of the coating x200 magnification (binocular microscope) 1 2 Insert with large descending coverage: m long beveled edge (1) to protect neck and preserve 3 rd articulation (between insert and neck) m second protective beveled edge (2) to prevent impingement between Morse taper and retaining rim Homogeneous layer of hydroxyapatite: m high purity (> 95%) needed for biological fixation of the impacted cup

compromise strength at the material's elastic limit and avoids any plastic deformation A Modeling of polyethylene stresses and deformation during passage of the head - A long descending insert:

5 Preventing instability The implant geometry, macrostructure and surface finish were developed so that optimal primary stability could be achieved without relying on the fixation screw 4 tropical spikes to prevent implant from tipping Flattened polar end cap to avoid bottoming out of cup and encourage equatorial press-fit HAP Quattro VPS cup Sizes 44 to 60* Quattro VPS cup Press Fit Sizes 44 to 60* Dual mobility insert Sizes 44 to 60, Ø 22.2 and 28 mm* *Refer to complete product reference number list 6 fins around the equator to provide rotational stability Bilayer coating consisting of vacuumplasma sprayed (VPS) porous titanium underlayer and hydroxyapatite layer Spherical shape with indentation for improved clearance Test report: Tipping resistance test for various cup configurations (data from manufacturer)

to 60* Dual mobility insert Sizes 44 to 60, Ø 22.

6 Optimizing reconstruction The Marc. K acetabular cross plate is a metal reinforcement guide used during acetabular reconstruction. In this indication, the benefits of dual mobility cups are indisputable because of - reduced stress - good stability Marc. K acetabular cross plate Sizes 4 to 6, left and right* CEM Quattro cup Sizes 44 to 56* Dual mobility insert Sizes 44 to 56, Ø 22.2 and 28 mm* Correspondence Marc. K cross plate with CEM Quattro cup Size Marc. K cross plate Quattro Quattro Ø 22 mm Ø 28 mm *Refer to complete product reference number list

K acetabular cross plate Sizes 4 to 6, left and right* CEM Quattro cup Sizes 44 to 56* Dual mobility insert Sizes 44 to 56, Ø 22.

7 Dual mobility is an effective technical approach to meet all the requirements of orthopedic surgeons who want to ensure that the joint is stable, leg length is equal and muscle tension is restored. GROUPE LEPINE is committed to making all of these needs co-exist with optimal and safe use of these implants, based on its manufacturing knowhow (1-3), which takes into account a unique mechanical environment, as well as a sound published clinical follow-up (4-9). BIBLIOGRAPHY 1. Aslanian T. Reprise de prothèse totale de hanche : contraintes et solutions industrielles. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: p Escaré P. Le cotyle élastique sans ciment MBA : résultats de 105 implantations à 9,5 ans de recul médian. Arthroplastie totale de hanche de 1ère intention : A la recherche du «Gold Standard». Sauramps Medical ed. Montpellier: p Connes H, Desbonnet P, Escaré P, Tricoire JL, Trouillas J. Du descellement à la migration de l implant cotyloïdien. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: p Long-term results of low-friction. arthroplasty of the hip performed as a primary intervention; J Bone Joint Surg Br February 1972 vol. 54-B no. 1, Prudhon JL. Présentation série rétrospective Quattro SICOT 2012 (Dubaï) 6. GUYEN MD O, SHAN CHEN Q, BEJUI-HUGUES J, J. BERRY D, Kai-Nan AN, Dual mobility hip implants: effect on hip stability, (Journées Lyonnaises de Chirurgie de la Hanche 2008) 7. Aslanian T. Les matériaux constitutifs des prothèses de hanche. Histoire, évolutions et tendances. Arthroplastie totale de hanche de 1ère intention : A la recherche du «Gold Standard». Sauramps Medical ed. Montpellier: p Aslanian T, Raossanaly C ; Verdier R. Les fractures d implant : rares et chères. Arthroplastie totale de hanche de 1ère intention : A la recherche du «Gold Standard». Sauramps Medical ed. Montpellier: p Trouillas J, Verdier R. Tige fémorale anatomique sans ciment MBA : apport de la modularité. Arthroplastie totale de hanche de 1ère intention : A la recherche du «Gold Standard». Sauramps Medical ed. Montpellier: p Tricoire JL. Le cotyle et son isthme iliaque : anatomie, anthropologie et biomécanique. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: p Desbonnet P, Tricoire JL, Connes H, Escaré P, Trouillas J. Le cotyle à plot «Intégra» dans les reprises d arthroplastie de hanche avec grande destruction osseuse. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: p Trouillas J, Escaré P, Connes H, Desbonnet P. Reconstruction métaphysaire et tige anatomique Le concept Intégra. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: p rue Jacquard - ZI Lyon Nord Genay - FRANCE TEL. +33 (0) FAX +33 (0) rue philosophe Tabrizi Les sources Bir Mourad Rais - ALGER lepine-algerie@groupe-lepine.com C/J.J. Tadeo Murguía N. 3-5 BAJO IRÚN (GUIPÚZCOA) lepine-iberica@groupe-lepine.com Via Cassanese, Segrate (Milano) lepine-italia@groupe-lepine.com 79 avenue IBN SINA RABAT - AGDAL lepine-maroc@groupe-lepine.com A / V1 / 07-13

environment, as well as a sound published clinical follow-up (4-9). BIBLIOGRAPHY 1. Aslanian T. Reprise de prothèse totale de hanche : contraintes et solutions industrielles.

8 Range of Quattro Cobalt-chrome cups HAP Quattro VPS cup Size 44 HQCHC HQCHC HQCHC HQCHC HQCHC HQCHC HQCHC HQCHC HQCHC060 HAP Quattro cup Press Fit Size 44 HQCPF HQCPF HQCPF HQCPF HQCPF HQCPF HQCPF HQCPF HQCPF060 CEM Quattro cup Size 44 HQCCC HQCCC HQCCC HQCCC HQCCC HQCCC HQCCC HQCCC HQCCC060 Correspondence Marc. K acetabular cross and CEM Quattro cup Size acetabular cross Marc.K Quattro VPS Quattro VPS Ø 22,2 mm Ø 28 mm Marc. K. acetab cross Size Side 4 right SI right SI right SI left SI left SI left SI Cortical bone screw Ø 5 mm Length 40 SI SI SI Dual-mobility liner Size Diameter 44 22,2 HQN DP ,2 HQN DP ,2 HQN DP ,2 HQN DP ,2 HQN DP ,2 HQN DP ,2 HQN DP ,2 HQN DP ,2 HQN DP HQN DM HQN DM HQN DM HQN DM HQN DM HQN DM HQN DM860

HQCCC054 56 HQCCC056 58 HQCCC058 60 HQCCC060 Correspondence Marc. K acetabular cross and CEM Quattro cup Size acetabular cross Marc.

9 HAP and CEM Quattro Cobalt-chrome cups Vacuum pump holder, Quattro VPS HQA VI003 Vacuum pump positionner HQA VI004 M10 impactor HQA VI002 Liner impactor HQA VI011 M10 Impaction end HMA TA009 Pump piston joint HQAJS011 M10 head impaction tip HMA TA008 Pump end joint HQAJS009 Pump plate joint Size 44 HQAJS028 46/48 HQAJS032 50/52 HQAJS036 54/56 HQAJS040 58/60 HQAJS044 Monobloc stem fork HQA VI010 Quattro VPS pump plate Size 44 HQA VI HQA VI HQA VI HQA VI HQA VI HQA VI HQA VI HQA VI HQA VI060 Liner impactor end HQA VI013 M10 trial cup Size 44 HL HL HL HL HL HL HL HL HL Dual-mob trial liner Size Diameter 44 22,2 HQA VN ,2 HQA VN ,2 HQA VN ,2 HQA VN ,2 HQA VN ,2 HQA VN ,2 HQA VN ,2 HQA VN ,2 HQA VN HQA VN HQA VN HQA VN HQA VN HQA VN HQA VN HQA VN860 Quattro VPS cup rack N1 HQA VP003 Quattro VPS cup rack N2 HQA VP005 Marc. K acetabular cross plate Marc. K. trial cross Size Side 4 right SA right SA right SA left SA left SA left SA Marc. K. acetabular cross holder HKA PA001 Depth gauge HL T handle screwdriver HEX 3.5 SA A01 Bowl UCAEC004 Drill Ø 3,2 L 200 GUA FX050 A02 Bowl UCAEC003 A01 small holes bowl UCAEC008 N 2 mini bowl UCAEC010 Universal rack H75 UCAPA001 Universal cover 534 X 249 UCACO001

VI010 Quattro VPS pump plate Size 44 HQA VI044 46 HQA VI046 48 HQA VI048 50 HQA VI050 52 HQA VI052 54 HQA VI054 56 HQA VI056 58 HQA VI058 60 HQA VI060 Liner impactor end HQA VI013 M10 trial cup Size

Biconical. MBA stem - a serene implant experience

Biconical. MBA stem - a serene implant experience MBA stem - a serene implant experience Joint biomechanics must be preserved during total hip arthroplasty. The need to adapt to specific anatomical situations requires the prosthesis to be perfectly positioned.